Drainage catheter system including a hub

ABSTRACT

A drainage device may include a catheter including a proximal end and a distal end. The drainage device may further include a hub coupled to the proximal end of the catheter. The hub may include a fastener element configured to secure the distal end of the catheter. In some aspects, the fastener element may be a hinged element. In some aspects, the drainage device may further include a puncture element including a tip and an expander portion. In still other aspects, the puncture element may also include an attachment portion.

CROSS-REFERENCE TO RELATED APPLICATION(S)

The present application is a continuation of U.S. patent applicationSer. No. 15/383,062, filed Dec. 19, 2016, which: (a) claims priority toand is a nonprovisional of U.S. Provisional Patent Application No.62/292,782 filed on Feb. 8, 2016 and entitled “Drainage CatheterIncluding a Hub”, and (b) claims priority to and is a nonprovisional ofU.S. Provisional Patent Application No. 62/383,370 filed on Sep. 2, 2016and entitled “Drainage Catheter System Including a Hub”. The content ofeach of the above applications is hereby incorporated by reference.

FIELD

The present disclosure is generally related to treating infections, andmore particularly to devices and methods configured to treat cutaneousand oral abscesses.

BACKGROUND

Surgical drains are used in a wide variety of different surgicalprocedures. Typically, such drains are used to drain fluid from asurgical area. Some examples where such drains are used may includeplastic surgery, breast surgery (to prevent collection of blood, lymphfluid, or both), orthopedic procedures, chest drainage, infected cysts,pancreatic surgery (to drain secretions), biliary surgery, thyroidsurgery, neurosurgery (to remediate risk of intracranial pressure),urinary catheters, nasogastric tubes, and other procedures.

One class of such surgical drains are used on patients with cutaneousand oral abscesses, or collections of pus, hematomas, seromas or anyother fluids requiring drainage. For example, abscesses can formanywhere in the body, from a superficial skin (subcutaneous) abscess todeep abscesses in muscle, organs, or body cavities. Treatment of suchabscesses typically involves draining the accumulated fluid (such aspus) to resolve the infection or cause of the abscess and to facilitaterecovery. One class of such surgical drains may require the patient or acare giver to adjust the drain to reopen clogged drainage paths tofacilitate drainage.

The approach used to drain the accumulated fluid may depend on the sizeand location of the abscess. For subcutaneous abscesses, treatmenttypically includes creating an incision through the layers of the skininto the abscess cavity using a scalpel, expressing fluid (e.g., pus)from the abscess, and optionally using a hemostat to explore the woundand to break up pockets or localized areas of hardened pus. In someinstances, packing material (such as a strip of gauze) may be insertedinto the abscess cavity to prevent skin closure and re-accumulation offluid in the abscess and to enable continued drainage. In otherinstances, a drainage catheter may be inserted through the incision andinto the abscess to facilitate drainage and optionally irrigation of theabscess cavity.

The approach to draining abscesses in the oral cavity typically includesincision through the mucosa to the abscess cavity using a scalpel,expressing fluid (e.g., pus) from the abscess, and optionally using ahemostat to explore the wound and to break up pockets or localized areasof hardened pus. In most instances, a small drain is sutured into thecavity of the abscess cavity to mucosal closure and re-accumulation offluid in the abscess and to enable continued drainage.

SUMMARY

In some embodiments, the herein disclosed drainage device may include acatheter including a proximal end and a distal end. The drainage devicemay further include a hub coupled to the proximal end of the catheter.The hub may include a fastener element configured to secure the distalend of the catheter. In some aspects, the fastener element may be ahinged element. In some aspects, the drainage device may further includea puncture element.

In some embodiments, a drainage device may include a catheter having aproximal end and a distal end and may include a hinged fastener coupledto the proximal end of the catheter. The hinged fastener may beconfigured to close over a portion of the catheter near the distal endto form a loop.

In still other embodiments, a drainage device can include a catheter anda puncture element. The catheter can include a proximal end and a distalend. The puncture element may be coupled to the distal end of thecatheter. Further, the puncture element can include a tip and anexpander portion including one or more cutting edges to extend anopening formed by the tip. The puncture element may further include anattachment portion configured to couple to the distal end of thecatheter. In some aspects, the drainage device may also include a hubcoupled to the proximal end of the catheter, the hub including afastener configured to secure the distal end of the catheter.

In certain embodiments, a practitioner may insert the distal end of acatheter into a first opening, though an abscess, and out of a secondopening. The catheter may include a fastener coupled to a proximal end.The method may further include coupling the distal end of the catheterto the fastener to form a loop. In some aspects, the fastener mayinclude a port or ports that can be accessed to deliver fluid into thecatheter.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A illustrates a diagram of a drainage catheter including apuncture element and a fastener, in accordance with certain embodimentsof the present disclosure.

FIGS. 1B and 1C depict diagrams of a puncture element and an attachmentmechanism, in accordance with certain embodiments of the presentdisclosure.

FIG. 1D depicts a diagram of a portion of the drainage catheterincluding an attachment mechanism of a puncture element and anattachment portion of a drainage catheter, in accordance with certainembodiments of the present disclosure.

FIG. 1E illustrates a catheter including an alternative embodiment of apuncture element, in accordance with certain embodiments of the presentdisclosure.

FIG. 1F depicts a portion of the puncture element of FIG. 1E.

FIG. 2A depicts a diagram of an embodiment of a hub including anattachment mechanism, in accordance with certain embodiments of thepresent disclosure.

FIG. 2B depicts a diagram of an embodiment of an attachment portion of adrainage catheter, in accordance with certain embodiments of the presentdisclosure.

FIG. 2C illustrates a side view of an embodiment of the attachmentportion of the drainage catheter of FIG. 2B, in accordance with certainembodiments of the present disclosure.

FIG. 3 depicts a diagram of an embodiment an abscess draining deviceincluding a hub with a fastener and including a port configured toreceive an irrigation fluid, in accordance with certain embodiments ofthe present disclosure.

FIG. 4 depicts a diagram of an embodiment an abscess draining deviceincluding a hub with a fastener and including a port configured toreceive an irrigation fluid, in accordance with certain embodiments ofthe present disclosure.

FIG. 5 depicts a diagram of an embodiment an abscess draining deviceincluding a hub with a fastener, a first port configured to receive anirrigation fluid, and a second port configured to receive a pressurizedfluid, in accordance with certain embodiments of the present disclosure.

FIG. 6A depicts a diagram of an abscess draining device including a hubwith a fastener and including a drainage catheter in situ, in accordancewith certain embodiments of the present disclosure.

FIG. 6B depicts a diagram of an abscess draining device including a hubwith a fastener and dual fluid ports and including a drainage catheterwith an uninflated balloon element in situ, in accordance with certainembodiments of the present disclosure.

FIG. 7 depicts a diagram of an abscess draining device including a hubwith a fastener and dual fluid ports and including a drainage catheterwith an inflated balloon element in situ, in accordance with certainembodiments of the present disclosure.

FIG. 8 depicts a diagram of an abscess draining device including a hubwith a fastener and a drainage catheter including irrigation holes and aballoon, in accordance with certain embodiments of the presentdisclosure.

FIG. 9 depicts a block diagram of an abscess draining device including ahub with a fastener and a drainage catheter, in accordance with certainembodiments of the present disclosure.

FIG. 10 depicts a diagram of a second abscess draining device in situand including a hub with a fastener and a drainage catheter includingirrigation holes, in accordance with certain embodiments of the presentdisclosure

FIGS. 11A-11C depict perspective views of a second abscess drainingdevice including a hub with a hinged fastener in an open position, inaccordance with certain embodiments of the present disclosure.

FIGS. 12A-12C depict perspective views of the second abscess drainingdevice of FIGS. 11A-11C with the hinged fastener in a closed position,in accordance with certain embodiments of the present disclosure.

FIGS. 13A-13C depict perspective views of a third abscess drainingdevice including a hub with a hinged fastener in an open position, inaccordance with certain embodiments of the present disclosure.

FIGS. 14A-14C depict perspective views of the third abscess drainingdevice of FIGS. 13A-13C with the hinged fastener in a closed position,in accordance with certain embodiments of the present disclosure.

FIGS. 15A-15C illustrate a method of suturing a drainage catheter deviceinto a wound, in accordance with certain embodiments of the presentdisclosure.

FIGS. 16A-16G depict a plurality of connectors that can be used tocouple a catheter to a hub (or a catheter to a puncture device), inaccordance with certain embodiments of the present disclosure.

FIG. 17A depicts a drainage device including a catheter with a ring andcollapsible elements configured to secure a portion of the catheterwithin the ring, in accordance with certain embodiments of the presentdisclosure.

FIG. 17B depicts a drainage device including a catheter with a ring andspherical elements configured to secure a portion of the catheter withinthe ring, in accordance with certain embodiments of the presentdisclosure.

FIG. 17C depicts a diagram of a drainage device of FIG. 17A, in situwithin a patient's mouth, in accordance with certain embodiments of thepresent disclosure.

FIG. 18 depicts a diagram of a hemostat, in accordance with certainembodiments of the present disclosure.

FIG. 19 depicts a diagram of a method of treating a cutaneous abscess,in accordance with certain embodiments of the present disclosure. Needlemay come attached to the catheter or require attachment by thepractitioner. In some embodiments the abscess cavity is irrigated afterthe drain is placed.

In the following discussion, the same reference numbers are used in thevarious embodiments to indicate the same or similar elements.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

Embodiments of devices and methods are described below that areconfigured to facilitate abscess drainage. In an embodiment, an abscessdrainage device may include a hub coupled to a catheter. The cathetermay include a proximal end coupled to the hub, a drainage portion, and adistal end. In some embodiments, the distal end of the catheter may becoupled to a puncture element, which may include a needle portion thatis curved, an expansion portion configured to enlarge an opening createdby a tip of the needle portion, and an attachment portion configured toengage the catheter.

In some embodiments, the distal end of the catheter may include afastening element configured to engage a fastener of the hub to form aloop. The fastening element can include at least one of a zip-tie, acinch-lock, a clip, a latch, a knot, a magnet, a barbed or double-barbedattachment, an adhesive, a chemical bond, a weld, a double-hinge clamp,an intermediate material bond, a ratchet, a hook-and-eye fabric, abuckle, a carabiner, a spring-loaded clamp, a directional clamp, aswage, a tube lock, a push-to-connect tube fitting, a crimp fitting, ashark bite fitting, and a piece of tape.

In some embodiments, the hub may include a fluid port to receive anirrigation fluid, and the catheter may include a lumen extending throughat least a portion of the catheter and including openings to deliverirrigation fluid from the lumen to a cutaneous abscess. Further, in someembodiments, the hub may include a second fluid port to receive a fluidunder pressure (such as air) to inflate a balloon associated with thecatheter. In this example, the catheter may include a second lumenextending between the second fluid port and the balloon.

In some embodiments, the fastener of the hub may be on an externalsurface of the hub or may extend through a portion of the hub that isseparate from the fluid ports and lumen. In a particular implementation,the fastener may include a zip-tie fastener configured to engage afastener portion (including ridges) at a distal end of the catheter. Instill other embodiments, the fastener may include an elastic bandconfigured to engage the hub and to secure the fastener portion to thehub. One possible example of a zip-tie implementation is described belowwith respect to FIG. 1A.

FIG. 1A depicts a diagram of a drainage catheter, generally indicated byreference number 100, including a puncture element and a fastener, inaccordance with certain embodiments of the present disclosure. Thedrainage catheter 100 may include a hub 110 coupled to or integratedwith a proximal end 112 of a catheter 102. The catheter 102 may includea fastener element 104 coupled to or integrally formed as part of adistal end 114 of the catheter 102 and configured to engage a fastenerof the hub 110 to secure the catheter 102 in a loop configuration. Thedrainage catheter 100 may further include a puncture element 108, suchas a needle or blade, which may be coupled to the fastener element 104by a coupling mechanism 106. The coupling mechanism 106 may include acrimped feature of the puncture element 108, which may be configured toreceive the distal end 114 of the catheter 102 and to be crimped tomechanically secure the distal end 114 to the puncture element 108.Further, in addition to crimping (or in lieu of crimping), the distalend 114 may be coupled to the puncture element 108 by an adhesive, by anadhesive and a mechanical crimp, by another type of connection, or anycombination thereof.

In some embodiments, the fastener element 104 may include a plurality ofridges, which may be configured to engage a locking feature within thefastener of the hub 110. Further, the fastener element 104 may include astopper 116, which may be a ridge that is larger than others of theridges and which may be configured to provide an end stop to thecoupling mechanism 106. In certain embodiments, the puncture element 108may be integrated with the coupling mechanism 106. The drainage catheter100 may be provided with the catheter 102 including the hub 110 and aplurality of puncture elements 108 from which a physician may select. Insome embodiments, the catheter 102, the hub, and a plurality of punctureelements 108 may be provided as a kit, and the physician may select andassemble the elements based on the particular wound to be treated Thephysician may select a suitable puncture element 108 and may couple thepuncture element 108 to the fastener element 104 by sliding the couplingmechanism 106 onto an end of the fastener element 104 and advancing thecoupling mechanism 106 until it engages the stopper 116. In analternative embodiment, the physician may slide the puncture element 108over an end of the catheter 102 and crimp the puncture element 108 (suchas with pliers) to grip the catheter 102. Other connections are alsopossible.

The physician may then advance the puncture element 108 through a firstincision, through an abscess and out of a second incision. The punctureelement 108 and the coupling mechanism 106 draw the catheter 102 alongthe path traversed by the puncture element 108, and the hub 110 mayoperate as a stopper to prevent the catheter 102 from being pulled outthrough the second incision.

Once the puncture element 108 exits the second incision and is pulledfar enough to expose at least a portion of distal end 114 of thecatheter 102, the physician may cut the fastener element 104 (or thecatheter 102) to remove the puncture element 108. In some embodiments,the fastener element 104 may include a “cut area” having no ridges tofacilitate cutting. Further, after the cut is made and the punctureelement 108 is removed, a portion of the fastener element 104 includingridges may remain and may be configured to engage a fastener of the hub110 to secure the distal end 114. The resulting configuration forms acatheter loop that extends into a first incision, through an abscess,and out from a second incision. The physician may pull on the loop toopen the incision sufficiently to enable insertion of a portion of ahemostat, which the physician may move around in order to dislodge thecollection of fluid within the abscess.

In some embodiments, the catheter 102 may be a silicone catheter, withor without the needle. The catheter 102 may be used as a drainage toolfor a variety of different wounds. Further, the catheter 102 may be usedto prevent infection in dirty wounds. These wounds may be cutaneouswounds from animal bites, injuries while swimming in lakes (fresh bodiesof water), on dirt or road/asphalt, or from other sources. The catheter102 may be inserted and formed into a loop, which can be sewn in,without (in any way) attaching the catheter to the skin of the patient.Such drainage without attachment is needed with a Penrose drain, whichis a surgical device named for the American gynecologist Charles BinghamPenrose (who died in 1925) and which device is placed in a wound todrain fluid. Thus, the catheter 102 may be used in lieu of such a drain.

As discussed above, a collection of puncture elements 108 may beprovided, which may include different sizes and shapes. In someembodiments, the curvature of the puncture elements 108 may also vary tofacilitate puncturing of abscesses at different depths. In someembodiments, the puncture element 108 may be formed from a deformablematerial, such as a thin metal, which may be bent or otherwise formed tohave a selected shape. Further, in some embodiments, the shape and sizeof the puncture element may remain consistent while the length of thecoupling mechanism 106 may vary. In some embodiments, the couplingmechanism 106 may be configured to be deformed (e.g., shaped, bent,curved, etc.) and to retain the adjusted shape to enable a physician toadjust a shape (e.g., curvature) of the coupling mechanism 106 accordingto a selected application. In some embodiments, both the shape of thepuncture element 108 and the length of the coupling mechanism 106 may beselected. Other embodiments are also possible.

In some embodiments, the hub 110 may include a fastener (such asfastener 202 in FIG. 2 ), which may be configured to secure the distalend 114 of the catheter 102 to the hub 110. While the illustratedexample of the fastener element 104 includes a side view of a zip-tietype of fastener, other embodiments are also possible. In an example,the fastener element 104 can include a zip-tie, a cinch-lock, a clip, alatch, a knot, a magnet, a barbed or double-barbed attachment, anadhesive, a chemical bond, a weld, a double-hinge clamp, an intermediatematerial bond, a ratchet, a hook-and-eye fabric, a buckle, a carabiner,a spring-loaded clamp, a directional clamp, a swage, a tube lock, apush-to-connect tube fitting, a crimp fitting, a shark bite fitting, anda piece of tape. In some examples, the fastener element 104 may be anydevice or element that can be configured to couple the distal end of thecatheter 102 to the hub 110.

FIGS. 1B and 1C are diagrams of devices 120 and 130 including a punctureelement 108 and an attachment mechanism 106, in accordance with certainembodiments of the present disclosure. In FIG. 1B, the device 120includes the puncture element 108 and a coupling mechanism 106. In theillustrated example, the coupling mechanism 106 is shorter than thepuncture element 108.

In FIG. 1C, the device 130 include a puncture element 108 and a couplingmechanism 106 that is longer than that of the device 120 in FIG. 1B. Thelonger coupling mechanism 106 provides versatility to allow a physicianto shape the coupling mechanism 106 along its length, if necessary. Insome embodiments, the coupling mechanism 106 may be pre-configured witha selected shape or curvature.

While the embodiments shown in FIGS. 1A-1C depict a single punctureelement 108, other puncture elements (such as that in FIG. 1E) havingdifferent shapes and sizes are also possible. Further, as mentionedabove, in some embodiments, the puncture elements 108 may be selectedfrom a plurality of possible puncture elements and may be coupled to thefastener element 104 by the coupling mechanism 106. One possible exampleof the coupling mechanism is described below with respect to FIG. 1D.

FIG. 1D depicts a diagram of a portion 140 of the drainage catheter 100including a coupling mechanism 106 of a puncture element 108 and anattachment portion of a drainage catheter 102, in accordance withcertain embodiments of the present disclosure. The coupling mechanism106 may include a locking mechanism 144 configured to engage ridges 142of the fastener element 104. The coupling mechanism 106 may be advancedonto the fastener element 104 until the coupling mechanism 106 engagesthe stopper 146. Other embodiments are also possible.

FIG. 1E illustrates a catheter 150 including an alternative embodimentof a puncture element (generally indicated at 108), in accordance withcertain embodiments of the present disclosure. In the illustratedexample, the puncture element 108 includes a first portion 152 having anarcuate or curved shape configured to draw the catheter 102 into,through and out from a wound. Further, the first portion 152 may includea tip or point 153 at its distal end that may be configured to puncturethrough layers of skin and cutaneous tissue as well as through a lesion.Further, the first portion 152 may be tapered along at least a portionof its length.

The puncture element 108 may include a second portion (or expanderportion) 154, which may include one or more cutting edges configured towiden an opening created by the tip or point 153 to facilitate drainageof the lesion. In the illustrated example, the second portion 154 mayinclude a cylindrical body corresponding to an outside diameter of thefirst portion 152 and including wings (or blades or edges) that maystick out from the surface of the cylindrical body to widen the openingcreated by the first portion 152. In a particular example, the catheterdevice 150 may include a puncture element 108 that includes an elongate,curved needle portion 152 with a puncture tip 153 that can be advancedthrough layers of skin and cutaneous tissue as well as through a lesion.In some embodiments, the cutting portion may be spaced apart from thepuncture tip 153 by a pre-determined distance. In a particular example,the cutting portion or second portion 154 may be positioned along thelength of the curved needle portion (first portion) 152 such that morethan half of the needle portion 152 will have passed through the skinand cutaneous tissue before the cutting portion 154 begins to expand theopening created by the needle portion 152.

In some examples, the cutting portion 154 can include wings or bladesthat may be sharp along distal edges 162 and may be blunt or roundedalong proximal edges 164 (as shown in FIG. 1F), making it possible toadvance the puncture element 108 through the tissue and through thewound in a direction of the tip or point 133, widening the opening bycutting with the distal edges 162. Further, because the proximal edges164 are blunt or dull, the puncture element 108 may be moved or pulledback toward the catheter 102 to break up solid portions of the fluidbuild-up to further facilitate drainage. In some embodiments, thecutting portion 154 may be formed by adding additional material (such asa metallic sleeve that can be slid over an outside diameter of a needle)and by applying pressure to deform at least the metallic sleeve at alocalized portion of the needle 152.

The puncture element 108 may include a third portion (attachmentportion) 156, which may have a substantially cylindrical shape with anopening (opening 166 in FIG. 1F). In some embodiments, the catheter 102may fit into the opening to couple the catheter 102 to the punctureelement 108. The interior surface of the third portion 156 that may besized to receive the catheter 102 may include hooks or barbs or may becrimped or any combination thereof to mechanically secure the catheter102 to the third portion 156. In some embodiments, an adhesive may beincluded within the opening 166 to further secure the catheter 102. Insome embodiments, a profile of the third portion 156 is smaller than theprofile of the second portion 154, but may be larger than a profile ofthe first portion 152.

FIG. 1F depicts a portion 160 of the puncture element 108 of FIG. 1E.The distal edges 162 of the second portion 154 may extend out from acylindrical body portion to form a cutting edge. Further, the proximaledges 164 of the second portion 154 may be rounded or blunt and maycurve toward the third portion 156.

In some embodiments, the third portion 156 may include an attachmentfeature configured to couple the puncture element 108 to the catheter102. In the illustrated example, the third portion 156 may include alumen or opening 166 sized to receive and secure an end of the catheter102. In one possible implementation, the interior surface of the opening166 may include an adhesive, one or more hooks, a ridge, another elementor feature, or any combination thereof to mechanically secure thecatheter 102 to the third portion 156. In an alternative embodiment, thethird portion 156 may include an opening (such as an eye of a needle)through which the catheter 102 may be fed to secure the catheter 102 tothe puncture element 108. Other embodiments are also possible.

FIG. 2A depicts a diagram of an embodiment of a hub 110 including anattachment mechanism, in accordance with certain embodiments of thepresent disclosure. The hub 110 includes a fastener 202 defining anopening 204 through which a fastener element 104 may be advanced. Thefastener 202 may include a locking element 206 within the opening andconfigured to engage ridges on the fastening element 104 to secure thedistal end of the catheter 102.

In certain embodiments, the fastener 202 may be coupled to an exteriorsurface of the hub 110. In other embodiments, the fastener 202 may beintegrally formed within the hub 110.

In some embodiments, the fastener element 104 may include sidewalls thatmay be configured to engage sides of the locking element 206. Onepossible embodiment of a fastener element 104 is described below withrespect to FIG. 2B.

FIG. 2B depicts a diagram of an embodiment of an attachment portion of adrainage catheter, in accordance with certain embodiments of the presentdisclosure. The fastener element 104 may include sidewalls 210 defininga channel 212 that includes ridges 122 and the stopper 116. Thesidewalls 210 may engage the sides of the locking element 206. Further,in the illustrated example, the stopper 116 is larger than the ridges122 to provide a stop for the connection mechanism 106. Further, in someembodiments, a second stopper 116 may be provided to engage a lockingelement 206 of a fastener of the hub 110 to prevent the catheter 102from being pulled too far. Other embodiments are also possible.

FIG. 2C is a side view of an embodiment of the attachment portion of thedrainage catheter of FIG. 2B, in accordance with certain embodiments ofthe present disclosure. The fastener element 104 may include a substrate220 and a plurality of ridges 122 formed thereon. The sidewalls 222 areshown in phantom. In an embodiment, the sidewalls 222 may be an exampleof the sidewall 210 in FIG. 2B. Further, a stopper 116 extends from thebase 220 to the same height as the sidewalls 222, while the ridges 122do not extend to the height of the sidewalls 222. The stopper 116 may beconfigured to engage the coupling mechanism 106 associated with thepuncture element 108.

The fastener element 104 may include a second stopper 224, which may beconfigured to engage a fastener associated with a hub 110 to prevent thefastener element 104 from being pulled past the locking mechanism of thefastener. Further, the fastener element 104 may include a cutting areahaving no ridges 122 to facilitate removal of the puncture element 108.In the illustrated example, a physician may cut through the fastenerelement 104 in the cutting area by cutting along dashed line 226. Bycutting in this area, the fastener element 104 is left with a portionthat includes ridges 104, even after cutting, which ridges may engage alocking mechanism of the fastener of the hub 110.

While the stoppers 116 and 224 are depicted as extending from thesubstrate 220 to a height of the sidewalls 222, the stoppers 116 and 224may be sized differently. In some embodiments, the stoppers 116 and 224may have the same height as the ridges 122, but may extend horizontallybeyond the exterior surface of the sidewalls 222, of the substrate 220,or both. In some embodiments, the stoppers 116 and 224 may be thickeralong a longitudinal axis of the fastener element 104. The stoppers 116and 224 may be configured to prevent advancing of the fastener element104 past a connection structure. Other embodiments are also possible.

FIG. 3 depicts a diagram of an embodiment an abscess draining device 300including a hub 302 with a fastener 303 and including a port 304configured to receive an irrigation fluid, in accordance with certainembodiments of the present disclosure. The abscess draining device 300may further include a catheter 102 including an irrigation portion 306and a solid portion 308. The catheter 102 may further include a fastenerelement 104 coupled to or forming a distal end.

In the illustrated embodiment, the port 304 may be configured to receivea sterile irrigation fluid, such as saline, or another fluid. The port304 may be coupled to a lumen 312 within the irrigation portion 306.Further, as shown in the expanded view, the lumen 312 extends within theirrigation portion 306 and is coupled to openings 314 to deliver thesterile irrigation fluid to the abscess. In the illustrated example, theopenings 314 are shown in a row extending substantially transverse to alongitudinal axis of the lumen 312; however, other arrangements of theopenings are also possible. Further, a physician can adjust the relativepositioning of the openings by adjusting the abscess draining device 300to irrigate a selected area.

In the illustrated example, a fastener 303 is coupled to an exteriorsurface of the hub 302. The fastener 303 may be an embodiment of thefastener 202 of FIG. 2 . The fastener 303 may be configured to securethe distal end 114 of the catheter 102 to the hub 302. While theillustrated example of the fastener element 303 includes a front view ofa zip-tie type of fastener, other embodiments are also possible. In anexample, the fastener element 303 can include a zip-tie, a cinch-lock, aclip, a latch, a knot, a magnet, a barbed or double-barbed attachment,an adhesive, a chemical bond, a weld, a double-hinge clamp, anintermediate material bond, a ratchet, a hook-and-eye fabric, a buckle,a carabiner, a spring-loaded clamp, a directional clamp, a swage, a tubelock, a push-to-connect tube fitting, a crimp fitting, a shark bitefitting, and a piece of tape. In some examples, the fastener element 303may be any device or element that can be configured to couple the distalend of the catheter 102 to the hub 302.

Further, the hub 302 may be an embodiment of the hub 110 of FIGS. 1A-2A.The fastener 303 may be configured to receive and secure a fastenerelement 104. In other embodiments, the fastener 303 may be integratedwithin the hub 302. One possible example of an integrated fastener isdescribed below with respect to FIG. 4 .

FIG. 4 depicts a diagram of an embodiment an abscess draining device 400including a hub 402 with a fastener and including a port configured toreceive an irrigation fluid, in accordance with certain embodiments ofthe present disclosure. The abscess draining device 400 includes all ofthe elements of the abscess draining device 300 of FIG. 3 . The hub 402is similar to the hub 302 of FIG. 3 except that the fastener 303 isintegrated into the hub 402. In an example where the fastener 303includes tape or a hook and eye fabric, one end may be coupled to thehub 402, while the other end hangs loose. Further, in some examples,such where the fastener is implemented as a clip, a portion of the clipmay be integrated with the hub 402 and a portion may be configured tomove relative to the hub 402 to implement a clasping or clamping actionto secure the distal end 114. Other embodiments are also possible.

In some embodiments, the fastener 303 include an opening extending fromone side of the hub 402 to the other so that the fastener element 104may be pulled through the fastener 303 and out the other side. In otherembodiments, the fastener 303 may include an opening that extendssubstantially parallel to the fluid opening 304, and the catheter 102may also extend substantially parallel to a longitudinal axis of thefluid opening 304. Other embodiments are also possible.

While the hub 402 described with respect to FIG. 4 includes a singlefluid opening for receiving the irrigation fluid, it is also possible toinclude a second fluid opening configured to receive a pressurized fluidfor inflating a balloon, for example. Further, when the catheterincludes a balloon, the position of the irrigation openings may vary.One example of a dual port hub and a catheter including irrigationopenings and a balloon is described below with respect to FIG. 5 ,

FIG. 5 depicts a diagram of an embodiment an abscess draining device 500including a hub 502 with a fastener 303, a first port configured toreceive an irrigation fluid, and a second port configured to receive apressurized fluid, in accordance with certain embodiments of the presentdisclosure. The hub 502 includes a fluid opening 304 for receiving anirrigation fluid. Further, the hub 502 may include a second port 504coupled to a second lumen 506 that extends to a balloon 508 adjacent tothe openings 314.

In the illustrated example, the pressurized fluid lumen 506 extends inparallel with the irrigation fluid lumen 312 to inflate the balloon 508in an area adjacent to the openings 314. In some embodiments, theopenings 314 may be on one side of the balloon 508. In otherembodiments, the openings 314 may be on both sides of the balloon 508,as shown. While only one opening 314 is shown, it should be appreciatedthat multiple openings may be provided.

FIG. 6A depicts a diagram of an abscess draining device 600 including ahub 608 with a fastener 616 and including a drainage catheter 610 insitu, in accordance with certain embodiments of the present disclosure.The hub 608 may be coupled to a proximal end 612 of the catheter 610,and the fastener 616 may couple the distal end 614 of the catheter 610to the hub 608. The catheter 610 may extend through a first incisionthrough the epidermis 602 and optionally through one or more layers ofthe dermis 604, through an abscess 606, and out from a second incision.The hub 608 includes an irrigation fluid port 618 to receive a sterileirrigation fluid. The catheter 610 includes a lumen coupled to theirrigation port 618 and coupled to openings 620, which are positionedwithin the abscess 606, to deliver irrigation fluid into the abscess606.

In the illustrated example, the fastener 616 may include an elasticportion configured to expand to receive the distal end 614 and toretract over the distal end to secure the catheter 610 to the hub 608.In another embodiment, the fastener 616 may include a hook and eyefabric configured to secure the distal end 614 to the hub 608. In analternative embodiment, the fastener 616 may be replaced with a zip-tiefastener, a locking fastener, or another type of fastener.Alternatively, the fastener 616 could be implemented as any one of azip-tie, a cinch-lock, a clip, a latch, a knot, a magnet, a barbed ordouble-barbed attachment, an adhesive, a chemical bond, a weld, adouble-hinge clamp, an intermediate material bond, a ratchet, a buckle,a carabiner, a spring-loaded clamp, a directional clamp, a swage, a tubelock, a push-to-connect tube fitting, a crimp fitting, a shark bitefitting, and a piece of tape. In a particular example, the fastenercould include a hinged element configured to close over the distal end614 of the catheter 610.

In the illustrated embodiment of FIG. 6A, the drainage catheter 600allows for introduction of irrigation fluid via the irrigation port 618and the openings 620. In some embodiments, an additional port may beprovided to allow for expansion of a balloon, for example. One possibleembodiment of a drainage catheter including a hub having two ports isdescribed below with respect to FIG. 6B.

FIG. 6B depicts a diagram of an abscess draining device 630 including ahub 608 with a fastener 616 and dual fluid ports (618 and 632), andincluding a drainage catheter 610 in situ, in accordance with certainembodiments of the present disclosure. In the illustrated example, thehub 608 may be coupled to a proximal end 612 of the catheter 610 and toa distal end 614 of the catheter 610 via the fastener 616. In additionto the openings 620, the catheter 610 may also include a balloon 634,which may be coupled by a lumen to a pressurized fluid port 632. Thecatheter 610 may be positioned such that the openings 620 and theballoon 634 are positioned within the abscess 606.

In certain embodiments, the physician may apply irrigation fluid to theirrigation port 618 and may selectively apply pressurized fluid to thepressurized fluid port 632 to inflate the balloon 634. In someembodiments, a physician may inflate the balloon 634 by applyingpressurized fluid to the pressurized fluid port 632 and then apply fluidto the irrigation fluid port 618. The balloon 634 may operate to confinethe irrigation fluid in a particular region within the abscess 606.Other embodiments are also possible.

FIG. 7 depicts a diagram of an abscess draining device 700 including ahub with a fastener and dual fluid ports and including a drainagecatheter in situ, in accordance with certain embodiments of the presentdisclosure. The abscess draining device 700 may include all of theelements of the abscess draining device 630 of FIG. 6B, except that theirrigation port 618 and the pressurized fluid port 634 are arrangeddifferently, reducing the overall size of the hub. Thus, hub 708 may besmaller than the hub 608 in FIG. 6B.

In the illustrated example, the irrigation port 718 and the pressurizedfluid port 732 may be aligned on opposing ends of the hub 708. In someembodiments, the catheter 610 may extend substantially perpendicular toa longitudinal axis of the hub 708 and may the fastener may be part ofthe hub and may receive the distal end of the catheter 610 along a paththat is substantially parallel to the direction in which the proximalend extends from the hub 708. In some embodiments, the catheter 710 mayextend from the hub 708 substantially parallel to the longitudinal axisof the hub 708, and the distal end of the catheter 710 may also coupleto a fastener of the hub 708 that extends parallel to the longitudinalaxis of the hub 708. In such an embodiment, the hub 708 may lay flatwith the flexible catheter loop.

As discussed above, the fastener may be implemented in a variety ofdifferent form factors and forms. In some embodiments, the fastener maybe implemented as at least one of a zip-tie connector, a cinch-lock, aclip, a latch, a knot, a magnet, a barbed or double-barbed attachment,an adhesive, a chemical bond, a weld, a double-hinge clamp, anintermediate material bond, a ratchet, a hook-and-eye fabric, a buckle,a carabiner, a spring-loaded clamp, a directional clamp, a swage, a tubelock, a push-to-connect tube fitting, a crimp fitting, a shark bitefitting, and a piece of tape. Further, the fastener can be coupled tothe hub 708 or integrated with the hub 708. Other embodiments are alsopossible.

FIG. 8 depicts a diagram of an abscess draining device 800 including ahub 802 with a fastener 820 and a drainage catheter 804 includingirrigation holes 816 and a balloon 814, in accordance with certainembodiments of the present disclosure. In the illustrated example, thehub 802 may include an irrigation port 806 and a pressurized fluid port808. Further, the fastener 820 may be between the irrigation port 806and the pressurized fluid port 808. The fastener 820 may be any of thetypes of fasteners described above with respect to FIGS. 1A-7 .

Further, in the illustrated example, the proximal end 810 of thecatheter 804 is coupled to the hub 802. Additionally, the balloon 814and one or more openings 816 may positioned along a surface of thecatheter 804 at a position 812 that may be located within an abscess.The catheter 804 may also include a fastener element 104 configured toengage the fastener 820.

In the expanded view, the balloon 814 may be inflated adjacent to theopenings 816. In some embodiments, the relative position of the balloon814 and the openings 816 within the abscess may be adjusted byselectively moving the drainage device within the wound. Further, insome embodiments, the balloon 814 may be inflated, deflated, andre-inflated to selectively apply pressure within the abscess.Additionally, irrigation fluid may be selectively provided to theirrigation port 806 to deliver irrigation fluid to the wound. Otherembodiments are also possible.

FIG. 9 is a block diagram of an abscess draining device 900 including ahub 902 with a fastener and a drainage catheter 904, in accordance withcertain embodiments of the present disclosure. In the illustratedexample, the proximal end 906 and the distal end 908 of the catheter 904extend from and return to the hub 902 along a plane that is parallel toa plane of the hub 902. The catheter 902 further includes a portion 910that is intended to be located within an abscess or other treatment areafor delivery of irrigation fluid, for inflation of a balloon, or both.Other embodiments are also possible.

In some embodiments, the fastener may be integrally formed as part ofthe hub 902, and the distal end of the catheter 904 may include afastener element to engage the fastener. In some embodiments, thefastener element may extend through the hub 902 via the fastener. Otherembodiments are also possible.

FIG. 10 depicts a diagram of a second abscess draining device 1000 insitu and including a hub 1002 with a hinged fastener 1016 and a drainagecatheter 610 including irrigation holes 620, in accordance with certainembodiments of the present disclosure. The hub 1002 may be coupled to aproximal end 612 of the catheter 610, which includes a distal end 614.The hinged fastener 1016 may be opened to receive the distal end 614 andmay be closed to clamp down onto the distal end 614 (as shown). Thehinged fastener 1016 may engage one or more catches to secure the hingedfastener 1016 in a closed position, applying a compressive force to thedistal end 614 and securing the distal end 614 within the hub 1002.

FIGS. 11A-11C depict perspective views of a second abscess drainingdevice including a hub with a hinged fastener in an open position, inaccordance with certain embodiments of the present disclosure. FIG. 11Ashows a top perspective view 1100 of a hub 1102 including a proximal end1104 and a distal end 1106. In some embodiments, the proximal end 1104may be configured to operate as a port that may be sized to receive asyringe. A lumen may extend from the proximal end 1104 to the distal end1106, as represented by the opening 1108.

The hub 1102 may include a hinged fastener 1112 coupled to the hub 1102and defining an enclosure, generally indicated at 1114. The hingedfastener 1112 may further include a fastener element 1116 configured toengage a corresponding fastener element 1118 associated with the hub1102 to close the hinged fastener 1112 over a distal end of the cathetertubing.

In certain embodiments, a proximal end of the catheter tubing may becoupled to the opening 1108 and the distal end of the catheter tubingmay extend through the skin, through the abscess and back out from theskin. The distal end may be secured within the enclosure 1114 by placingthe distal end within the enclosure 1114 and closing the hinged fastener1112 such that the hinged fastener 1112 can secure the distal end of thecatheter tubing to the hub 1102.

FIG. 11B depicts a bottom perspective view 1120 of the hub 1102. Theproximal end 1104 may include a threaded portion configured to engage acorresponding structure of the syringe or other element.

FIG. 11C illustrates a front view 1130 of the hub 1102 taken from theperspective of the distal end 1106. As shown, the enclosure 1114includes a ledge 1132 configured to receive the distal end of thetubing. The fastener element 1116 is configured to engage thecorresponding fastener 1118 to close the hinged element 1112 over thedistal end of the tubing.

FIGS. 12A-12C depict perspective views of the second abscess drainingdevice of FIGS. 11A-11C with the hinged fastener 1112 in a closedposition, in accordance with certain embodiments of the presentdisclosure. In FIG. 12A, a top perspective view 1200 of the hub 1102shows the hinged element 1112 clamped over the distal end of the tubing.

In FIG. 12B, a bottom perspective view 1220 of the hub 1102 is shown. InFIG. 12C, a front perspective view 1230 of the hub 1102 is shown. Insome embodiments, the hub 1102 may be formed from a flexible, rubber orsilicone material that can be compressed, bent, or otherwise deformed.

In the embodiments of FIGS. 12A-12C, the hub 1102 can be approximatelythe size of a pinto bean when closed. By providing a hinged element 1112that can close to engage the distal end of the catheter tubing, the hub1102 can facilitate the surgical procedure. By providing a small sizedhub 1102, the hub 1102 can be comfortably worn after the surgery.

FIGS. 13A-13C depict perspective views of a third abscess drainingdevice including a hub with a hinged fastener in an open position, inaccordance with certain embodiments of the present disclosure. FIG. 13Ashows a top perspective view 1300 of a hub 1302 including a proximal end1304 and a distal end 1306. A lumen may extend from the proximal end1304 to the distal end 1306, as represented by the opening 1308.

The hub 1302 may include a hinged fastener 1312 coupled to the hub 1302and defining an enclosure, generally indicated at 1314. The hingedfastener 1312 may further include a fastener element 1316 configured toengage a corresponding fastener element 1318 associated with the hub1302 to close the hinged fastener 1312 over a distal end of the cathetertubing.

In certain embodiments, a proximal end of the catheter tubing may becoupled to the opening 1308 and the distal end of the catheter tubingmay extend through the skin, through the abscess and back out from theskin. The distal end may be secured by placing the distal end within theenclosure 1314 and closing the hinged fastener 1312 such that the hingedfastener 1312 can secure the distal end of the catheter tubing to thehub 1302.

FIG. 13B depicts a bottom perspective view 1320 of the hub 1302. Theproximal end 1304 may include a threaded portion configured to engage acorresponding structure of the syringe or other element.

FIG. 13C illustrates a front view 1330 of the hub 1302 taken from theperspective of the distal end 1106. The fastener element 1316 isconfigured to engage the corresponding fastener 1318 to close the hingedelement 1312 over the distal end of the tubing.

FIGS. 14A-14C depict perspective views of the second abscess drainingdevice of FIGS. 13A-13C with the hinged fastener 1312 in a closedposition, in accordance with certain embodiments of the presentdisclosure. In FIG. 14A, a top perspective view 1400 of the hub 1302shows the hinged element 1312 clamped in a closed position, such as whenthe catheter tubing is secured by the hinged element 1312.

In FIG. 14B, a bottom perspective view 1420 of the hub 1302 is shown. InFIG. 14C, a front perspective view 1430 of the hub 1302 is shown. Insome embodiments, the hub 1302 may be formed from a flexible, rubber orsilicone material that can be compressed, bent, or otherwise deformed.

In the embodiments of FIGS. 14A-14C, the hub 1302 can be approximatelythe size of a pinto bean (or smaller) when closed. By providing a hingedelement 1312 that can close to engage the distal end of the cathetertubing, the hub 1302 can facilitate the surgical procedure. By providinga small sized hub 1302, the hub 1302 can be comfortably worn after thesurgery.

FIGS. 15A-15C illustrate a method of suturing a drainage catheter deviceinto a wound, in accordance with certain embodiments of the presentdisclosure. In FIG. 15A, perspective view 1500 is shown that includes asurface 1502 including an open wound 1504 that may require sutures.

In FIG. 15B, a perspective view 1510 is shown that includes a drainagesystem. The drainage system may include a catheter including a proximalportion 1514, a distal portion 1518, and a portion 1516 in contact withthe wound. In some embodiments, the drainage system may further includea hub 1512, which can be an embodiment of any of the hubs depicted anddescribed with respect to any of the FIGS. 1-14C. In some embodiments, auser may select a hub 1512 (such as any of the embodiments describedabove) and a catheter from a plurality of available options. Thecatheter, for example, may include an inflatable feature, openings forirrigation, or any of the other catheter features described above. Theuser may then assemble the irrigation device by coupling the proximalend 1514 of the selected catheter to the selected hub 1512. The user maythen position the portion 1516 in contact with the wound.

In FIG. 15C, a perspective view 1520 is shown that includes the drainagesystem sutured in place in the closed wound 1524 by a plurality ofsutures 1526. In this example, the portion 1516 may be sown (or sutured)into the wound to facilitate drainage.

It should be appreciated that many of the examples described aboveassumed that a puncture element was needed to access the wound orabscess to be drained. However, some wounds may be open prior totreatment, and the drainage system may be used to drain such woundswithout using a puncture element. Other embodiments are also possible.

FIGS. 16A-16G depict a plurality of connectors that can be used tocouple a catheter to a hub (or a catheter to a puncture device), inaccordance with certain embodiments of the present disclosure. In FIG.16A, a block diagram 1600 of a drainage system is shown that includes ahub 1602 coupled to a catheter 1606 by a connector 1604. The connector1604 can be a clamp connector, a strap connector, a cinch connector, amagnetic connector, a bolt/nut connector, a cinch-lock connector, aratchet connector (such as depicted in FIGS. 2A-2C), an adhesiveconnector, a hook and eye connector, a buckle, a crank or winding, aloop/hook connector, a weld (mechanical or chemical) connection, a tubelock connector, or other connector. Some of the types of connectors aredepicted below for ease of understanding. Further, it should beappreciated that the connector (or similar connectors) may be used toconnect both the proximal and distal ends of the catheter to the hub.Some of the connector types may also be used to couple the catheter 1606to a puncture element.

In FIG. 16B, a block diagram 1610 of a drainage system includes a hub1602 coupled to a catheter 1606 by a magnetic coupling including a firstmagnet 1612 coupled to the hub 1602 and a second magnet 1614 coupled tothe catheter 1606.

In FIG. 16C, a block diagram 1620 of a drainage system includes a hub1602 with a connector 1622 including at least one barb 1624. Thecatheter 1606 may be pressed onto the connector 1622 over the barb 1624to couple the catheter 1606 to the hub 1602.

In FIG. 16D, a block diagram 1630 of a drainage system is disclosed thatincludes a cinch-lock type of connector 1632 configured to couple thecatheter 1606 to the hub 1602.

In FIG. 16E, a block diagram 1640 of a drainage system is shown thatincludes a buckle 1644, which may be coupled to the hub 1602 by anattachment feature 1642. In this example, the attachment feature 1642may include a flexible strap. In an alternative embodiment, the buckle1644 may be coupled to the hub 1602 by an adhesive or another coupling.In the illustrated example, the catheter 1606 may be coupled to the hub1602 by weaving the end of the catheter 1606 through the buckle 1644.

In FIG. 16F, a block diagram 1650 of a drainage system is shown thatincludes a loop 1652 coupled to the hub 1602 and a hook 1654 coupled tothe catheter 1606. In an example, the loop 1652 and the hook 1654 may bepart of a hook and eye fabric combination that can be used to secure thecatheter 1606 to the hub 1602. In an alternative example, a hook 1654may be coupled to or formed from the end of the catheter 1606 andconfigured to engage the loop 1652 associated with the hub 1602.

In FIG. 16G, a block diagram 1660 of a drainage system is shown thatincludes a tub lock 1664 coupled to the hub 1602 and configured toengage and secure an end of the catheter 1606. The tube lock 1664 may bean example of a push-to-connect type of fitting, a crimp fitting, or ashark-bite fitting that can receive and grip the catheter 1606.

While the above-examples included mechanical coupling features, itshould be appreciated that the catheter 1606 may be coupled to the hub1602 using adhesives, a mechanical (or chemical) weld, or otherfeatures. In a particular example, the catheter 1606 may be coupled tothe hub 1602 by a bolt/nut combination. For example, the end of thecatheter may include a nut configured to engage a threaded post or boltof the hub 1602. In another embodiment, the catheter 1606 may includeridges or impressions configured to engage corresponding impressions orridges in the connector 1604 of the hub 1602, securing the catheter 1606to the hub 1602. Other embodiments are also possible.

FIG. 17A depicts a drainage device 1700 including a catheter 1702 with aring 1710 and collapsible elements 1712 configured to secure a portionof the catheter 1702 within the ring 1710, in accordance with certainembodiments of the present disclosure. The catheter 1702 may include aproximal portion adjacent to the ring 1710 and a distal portion, whichmay be coupled to a curved needle 1708 by a fastening element 1704. Insome embodiments, the fastening element 1704 may include a crimpedportion, an adhesive, or any combination thereof.

In some embodiments, the collapsible elements 1712 may collapse when thecatheter 1702 is pulled through tissue, an abscess, or the opening inthe ring 1710. The collapsible element 1712 may then expand to preventthe distal end of the catheter 1702 from being pulled back through thering 1710. In some embodiments, the ring 1710 may include a metallicelement that may maintain the shape of the ring 1710. Further, if thepatient were to ingest the catheter 1702 by accident, the metallicelement may be detectable using X-rays or other medical procedures.Other embodiments are also possible.

FIG. 17B depicts a drainage device 1720 including a catheter 1702 with aring 1710 and spherical elements 1722 configured to secure a portion ofthe catheter 1702 within the ring 1710, in accordance with certainembodiments of the present disclosure. In this example, the sphericalelements 1722 may be at least partially compressible to fit through theopening of the ring 1710 and to prevent the catheter 1702 from beingpulled back through the ring 1710.

FIG. 17C depicts a diagram 1730 of a drainage device 1700 of FIG. 17A,in situ within a patient's mouth, in accordance with certain embodimentsof the present disclosure. In the illustrated example, a portion of thepatient's gums 1734 and associated teeth 1732 are shown. The proximalend of the catheter 1702 and the distal end of the catheter 1702 areexternal to the gums 1734. A portion of the catheter 1702 (which isbetween the proximal and distal ends) may extend within the patient'sgums. The distal end of the catheter 1702 is threaded through theopening in the ring 1710, and the collapsible element 1712 prevents thecatheter 1702 from being pulled back through the ring 1710.

In this example, removal of the drainage device 1700 (or the drainagedevice 1720) may be accomplished by cutting the catheter 1702 betweenthe ring 1710 and the gums 1734 and pulling the drainage device 1700.Rather than using other types of drainage devices, the drainage device1700 enables a simple insertion and simple removal. More importantly,the small openings for insertion reduce the possibility of infection,and the simplified withdrawal procedure reduces or eliminates the needfor a second surgery to remove the drainage device 1700 as compared toother drainage devices and solutions.

FIG. 18 depicts a diagram of a hemostat 1800, in accordance with certainembodiments of the present disclosure. The hemostat 1800 includeshandles 1801 configured to engage a user's fingers. The hemostat 1800may further include a first arm 1802 and a second arm 1804 coupledtogether at a pivot location 1806 to provide a scissor/gripper function.The first arm 1802 and the second arm 1804 cooperate to provide acutting element 1808 and a gripper element 1810. Further, the arm 1802includes an extension 1812, which is rounded and configured to be movedaround within the abscess. The extension 1812 may be curved. Further,the extension 1812 may be rounded so that the extension does not cuttissue.

In an embodiment, the physician may insert the drainage catheter and mayuse the gripper element 1810 to advance the catheter through theepidermis, the through the abscess. Once the distal end of the catheteris coupled to the fastener of the hub, the physician may pull on the hubto expand the opening to allow the physician to insert the extension1812 through the same incision as the catheter. The physician may thenmove the extension around to help to dislodge the accumulated fluid.Other embodiments are also possible.

FIG. 19 depicts a diagram of a method 1900 of treating a cutaneousabscess, in accordance with certain embodiments of the presentdisclosure. At 1902, the method 1900 may include selectively coupling apuncture element to an attachment portion at a distal end of a drainagedevice that includes a hub coupled to a proximal end of the drainagedevice. In some embodiments, the puncture may include a puncture elementand a coupling mechanism such as the third portion (or attachmentportion) 136 in FIGS. 1E and 1F, which may engage a fastener element ofa drainage catheter. In a particular example, the puncture element mayinclude a first portion that includes a tip or point and that is curvedor arcuate-shaped. Further, the puncture element may include a secondportion including wings or protrusions having a sharpened distal edgeand a blunt or smooth proximal edge. Additionally, the puncture elementmay include a third portion that may include one or more attachmentfeatures configured to engage and secure the catheter to the thirdportion. In an example, the attachment features may include an adhesive,an opening sized to receive the end of the catheter, hooks (ridges orteeth) configured to mechanically grip the end of the catheter, otherattachment features, or any combination thereof. In one particularexample, the end of the catheter may be inserted into an opening of thethird portion of the puncture element, and the third portion may becrimped or bent to mechanically secure the puncture element to thecatheter. In still another possible embodiment, the third portion mayinclude an opening (similar to the eye of a needle) through which thecatheter may be threaded to secure the catheter to the puncture element.Other embodiments are also possible.

At 1904, the method 1900 may include threading the puncture element andthe drainage device through a first opening and an abscess and outthrough a second opening. In an embodiment, the drainage device mayinclude a catheter that may be attached to the puncture element anddrawn through the epidermis, through the abscess, and back through theepidermis. The puncture element may include a tip or point, a curvedportion, an expander portion that includes one or more blades extendinglaterally to expand the opening created by the tip. In some embodiments,a portion of the catheter may include openings, a balloon, or both,which may be positioned within the abscess.

At 1906, the method 1900 may include detaching the puncture element fromthe attachment portion. In an example, the puncture element may bedetached by cutting through a cut area provided in the attachmentportion or by cutting the catheter at a location adjacent to thepuncture element. At 1908, the method 1900 may include selectivelycoupling the attachment portion to a fastener of the hub to form a loop.In some embodiments, the fastener and the attachment portion maycooperate to form a zip-tie type of attachment. In other embodiments,the attachment portion may include a clip or fastener that may be closedover the catheter to secure the distal end of the catheter and to holdthe catheter in a loop shape. In some embodiments, the fastener mayextend through at least a portion of the hub. Further, in someembodiments, the hub may include an irrigation port, a pressurized fluidport, or both. Other embodiments are also possible.

In conjunction with the devices described above with respect to FIGS.1A-17C and 19 , a drainage device is disclosed that includes a hub and acatheter having a proximal end coupled to the hub. The hub may include afastener configured to engage a distal end of the catheter to form aloop that extends through a first incision in the epidermis, through anabscess or other structure to be drained, and back through a secondincision in the epidermis. The fastener may be a zip-tie fastener, cinchlock, a clip, a latch, a knot, a magnet, a barbed or double barbedattachment, glue/adhesive/cement, chemical bond/weld, double hingeclamp, intermediate material bond, ratchet, Velcro, buckle, carabiner,spring loaded clamp, directional clamp, swage, tube lock, “push toconnect” tube fitting, crimp fitting, shark bite fitting, tape oranother type of fastener configured to engage and secure the distal endof the catheter.

In some embodiments, the hub may include an irrigation port to receive asterile irrigation fluid and the catheter may include a lumen extendingfrom the irrigation port to openings in the catheter. In someembodiments, the openings may be positioned within a treatment area todeliver the irrigation fluid. In some embodiments, the hub may include apressurized fluid port and the catheter may include a pressurized fluidlumen extending from the pressurized fluid port to a balloon.

Further, in conjunction with the hemostat of FIG. 18 , a tool isdescribed that may be used in conjunction with the drainage devices ofFIGS. 1A-17C and 19 . In an example, the hemostat may include a grippingelement configured to engage a needle or puncture element to guide thepuncture element and the attached catheter through the epidermis and theabscess. Further, once the puncture element is pushed back through asecond incision of the epidermis, the physician may utilize the cuttingelement of the hemostat to cut off the puncture element. The hemostatmay be used to cut portions of the faster element and an extensionelement of the hemostat may be inserted through one of the incisions andmoved around to facilitate the treatment.

While the above discussion has focused on implementations of thedrainage catheter system used with abscesses, the drainage cathetersystems and embodiments described above may be used with other drainagesituations including, but not limited to plastic surgery, breast surgery(to prevent collection of blood, lymph fluid, or both), orthopedicprocedures, chest drainage, infected cysts, pancreatic surgery (to drainsecretions), biliary surgery, thyroid surgery, neurosurgery (toremediate risk of intracranial pressure), urinary catheters, nasogastrictubes, and other procedures. In some embodiments, such as oral surgery,the hub may be smaller in order to reduce irritation. In otherembodiments, the hub may be larger in order to facilitate access tofluid ports. Other embodiments are also possible.

Although the present invention has been described with reference topreferred embodiments, workers skilled in the art will recognize thatchanges may be made in form and detail without departing from the scopeof the invention.

What is claimed is:
 1. An apparatus comprising: a hub including a hubchannel; a flexible conduit coupled to the hub; and a blade coupled tothe conduit; wherein: (a)(i) the hub channel is coupled to a firstportion of the conduit; and (a)(ii) the first portion of the conduit ishollow; wherein: (b)(i) in a first configuration the conduit and the hubcouple to each other in a non-loop orientation; (b)(ii) in a secondconfiguration the conduit and the hub couple to each other in a looporientation, the loop orientation including a loop having acircumference; (b)(iii) in a third configuration the conduit and the hubcouple to each other in an additional loop orientation, the additionalloop orientation including an additional loop having an additionalcircumference; (b)(iv) the additional circumference is smaller than thecircumference; wherein: (c)(i) the first portion of the conduit includesa first aperture, the first aperture to fluidly couple an externalirrigation source to the conduit via the hub channel; (c)(ii) a secondportion of the conduit includes at least one second aperture in asidewall of the conduit; (c)(iii) the conduit includes a lumen thatcouples the first aperture to the at least one second aperture; (c)(iv)a third portion of the conduit is coupled to the blade; and (c)(v) thesecond portion of the conduit is between the first and third portions ofthe conduit; wherein: (d)(i) in the first configuration the firstportion of the conduit couples to the hub and the third portion of theconduit does not directly contact the hub; (d)(ii) in both of the secondand third configurations the third portion of the conduit directlycontacts the hub; (d)(iii) the first, second, and third portions of theconduit collectively include the lumen; (d)(iv) the lumen is open in thefirst portion of the conduit; (d)(v) in each of the first, second, andthird configurations the lumen is open in the third portion of theconduit; and (d)(vi) in a fourth configuration the hub seals the lumenand the lumen is closed in the third portion of the conduit.
 2. Theapparatus of claim 1 wherein: the blade includes: (a)(i) a long axisalong a length of the blade, and (a)(ii) a short axis that is orthogonalto the long axis; the blade comprises: (b)(i) a first blade portionincluding a first width measured parallel to the short axis, and (b)(ii)a second blade portion including a second width measured parallel to theshort axis; the first blade portion is between the third portion of theconduit and the second blade portion; the first width is greater thanthe second width.
 3. The apparatus of claim 2 wherein: the bladeincludes a third blade portion; the second blade portion is between thefirst and third blade portions; the third blade portion is curved in aplane, the plane being parallel to the long axis.
 4. The apparatus ofclaim 3 wherein the second blade portion includes at least one cuttingedge.
 5. The apparatus of claim 4 wherein the second blade portionincludes two cutting edges that are not contiguous with one another. 6.The apparatus of claim 5 wherein each of the two cutting edges taperoutwardly as each of the two cutting edges progresses toward the thirdportion of the conduit.
 7. The apparatus of claim 6 wherein: the thirdblade portion does not include the two cutting edges; each of the twocutting edges taper outwardly as each of the two cutting edgesprogresses away from the third blade portion.
 8. The apparatus of claim7 wherein: the third blade portion comprises more than 50% of an overalllength of the blade; a majority of the third blade portion is nottapered.
 9. The apparatus of claim 1 wherein in the fourth configurationthe hub compresses the third portion of the conduit to narrow the lumenin the third portion of the conduit.
 10. The apparatus of claim 9wherein the hub includes a lock to lock the third portion of the conduitto the hub.
 11. The apparatus of claim 9 wherein: the hub includes anadditional channel to receive the third portion of the conduit; asub-portion of the third portion of the conduit directly contacts theadditional channel in the second configuration; another sub-portion ofthe third portion of the conduit directly contacts the additionalchannel in the third configuration; the additional channel extends fromone side of the hub to another side of the hub.
 12. The apparatus ofclaim 9 wherein in the fourth configuration the hub is configured tosimultaneously compress the third portion of the conduit to narrow thelumen while communicating irrigating fluid from the hub channel to theat least one second aperture in the sidewall of the conduit.